Summary Findings of the Association of Continuity With Cost and Use Outcomes (N = 160 Outcomes)
Outcome Category | No. of Outcomes | Association of Continuity With Outcome | ||
---|---|---|---|---|
Positivea | Negative | None or Conflicting | ||
Cost | 18 | 14 | 1 | 3 |
Use | 142 | 95 | 4 | 43 |
Hospitalization | 57 | 38 | 1 | 18 |
ASCS | 20 | 14 | 1 | 5 |
All cause | 27 | 20 | 0 | 7 |
Other | 10 | 4 | 0 | 6 |
ED use | 43 | 35 | 1 | 7 |
Desirable useb | 15 | 7 | 1 | 7 |
Undesirable usec | 12 | 8 | 0 | 4 |
Primary care used | 15 | 7 | 0 | 8 |
ACSC = ambulatory care–sensitive conditions; ART = antiretroviral therapy; CRC = colorectal cancer; CT = computed tomography; ED = emergency department; HbA1c = glycated hemoglobin; ICU = intensive care unit; LDL = low-density lipoprotein cholesterol; LVF = left ventricular function; TB = tuberculosis.
↵a Greater continuity was associated with lower costs or with better use outcome (more use of desirable health care services or less use of undesirable health care services).
↵b Guideline-concordant receipt of vaccinations; lead, anemia, and TB screening; prescription drug use; HbA1c screening; annual LDL screening; annual nephropathy screening; annual serum creatine screening; annual LVF test for patients with heart failure; breast, cervical, CRC, and prostate cancer screening; chlamydia screening; recognition of chronic disease; HIV ART adherence; medication/statin adherence; receipt of medical advice about child nutrition, development, and dental health; primary care follow-up within 30 days of inpatient stay.
↵c CT scan of brain, chest radiograph, and urinalysis; total inpatient and outpatient days; duplicated medication (being prescribed drugs in the same pharmacotherapeutic subgroups by separate physicians with overlapping prescription days); use and overuse of various medical procedures; antibiotic prescriptions; ICU use.
↵d Frequency, number, and type (eg, routine well care) of visits to primary care.